Population health and prevention

Population health and prevention

Population health and prevention is the ‘golden thread’ that runs through the Better Lives Lincolnshire strategy and underpins its focus on improving health and wellbeing and tackling inequity.

A person’s physical and mental health and wellbeing are influenced throughout life by a diverse range of social, economic and environmental factors, known as the wider determinants of health. Addressing the wider determinants of health will help improve overall health by helping to improve the conditions into which people are born, live and work. Addressing these determinants throughout the life course allows us to consider the critical stages, transitions, and settings where large differences can be made in promoting or restoring health and wellbeing.

This life course approach underpins how we plan to deliver the priorities set out in the JHWS, recognising that:

  • There are a wide range of protective and risk factors that interplay in health and wellbeing over the life span.
  • By altering policies, environments, and societal norms, inequalities affecting the life course trajectory can be reduced, which could benefit the whole population now and in the future.

This means taking action:

  • To protect and promote health during important transition periods early and appropriately across the life course.
  • To create healthy environments and improve conditions of daily life together as a society.
  • To reduce health inequalities throughout the life course.

In line with the life course model, our delivery of this enabler will focus around four themes:

  • Theme 1: Preconception, infancy and early years (0-5)
  • Theme 2: Childhood and adolescence (5-19)
  • Theme 3: Working age (16-64)
  • Theme 4: Ageing well

  • Theme 1: Preconception, infancy and early years (0 - 5)

    What happens during pregnancy and the first few years of life influences physical, cognitive and emotional development in childhood and may influence health and wellbeing outcomes in later life. In addition to the critical events that shape an individual’s health trajectory, the number and sequence of exposures to risk and periods of increased susceptibility, some of which occur before birth or are genetically inherited, are also crucial.

    The preconception period presents an opportunity for professionals to encourage women and men to adopt healthier behaviours in preparation for a successful pregnancy and positive health outcomes for both themselves and their child. We will therefore focus on interventions such as:

    • Being aware of screening before or during pregnancy.
    • Being up to date with all vaccinations before and during pregnancy.
    • Taking folic acid supplements.
    • Eating a healthy diet and being physically active.
    • Giving up smoking, and reducing or stopping alcohol consumption.
    • Expanding oral health promotion activities.

    The earliest years of life set the tone for the whole of the lifespan. There is strong evidence that intervening in the first 1,001 days of a child’s life can make a difference over their whole lifetime. During this period the brain displays a remarkable capacity to absorb information and adapt to its surroundings.

    Positive early experience is therefore vital to ensure children are ready to learn, ready for school and have good life chances. It is shaped by several factors such as sensitive attuned parenting, effects of socio economic status and the impact of high quality early education and care.

    Improving children and young peoples’ mental wellbeing will have a positive effect on their cognitive development, learning, physical health, and their mental health, social and economic prospects in adulthood. It is known that poor social and emotional well being in young children can lead to behaviour and developmental problems and, later in childhood, severe depression, anxiety, self harm and other poor mental health outcomes.

    The areas we will focus interventions on include:

    • Improve speech, language and communication skills in the under 5s.
    • Prioritise early intervention through additional investment in children’s centres and family hubs.
    • Increase uptake of childhood vaccinations.
  • Theme 2: Childhood and adolescence (5-19)

    Children and young people face many new challenges and experiences as they grow and develop; part of growing up includes experimenting and trying new things, but adolescence can be a very difficult time for some. We know that approximately 1 in 7 young people experience at least one mental disorder, and emotional disorders – such as anxiety and depression – can be commonplace. If left unaddressed, these problems often persist into adulthood.

    Adolescence, defined as the transitional phase between childhood and adulthood, is a time when young people begin developing habits that will carry over into adulthood. Healthy behaviours initiated in childhood, such as physical activity and healthy nutrition, should be maintained during adolescence.

    In light of this we will focus our interventions in the following areas:

    • Tackling vulnerabilities and adverse childhood events (ACEs) and safeguarding children.

    • Supporting young people’s mental health and emotional wellbeing.

    • Improving educational attainment.

    • Tackling tobacco, alcohol and drug use.

    • Increase the motivation, confidence and physical competence in relation to physical activity.

    • Reducing the number of teenage pregnancies and improving outcomes for young parents and their children.

    • Increase uptake of school-age vaccination.
  • Theme 3: Working age (16-64)

    Emphasis on a good start in life does not mean that actions at later stages of the life course are not important. Adulthood is an important time for building assets, reducing risks and intervening early.

    This stage is crucial as it is a time of significant opportunity to build resilience for later life, to reinforce the improvement in skills and individual empowerment provided by a good start but also to achieve greater health equity among the existing adult population. In particular, it is essential to reduce stress at work, reduce long term unemployment through active labour market programmes and address the causes of social isolation. Throughout this period, professionals can ensure that they make every contact count and use everyday interactions with people to support them in making positive changes to their physical and mental health and wellbeing, as well as promoting services such as the NHS Health Check.

    The NHS Health Check offers an opportunity to assess the top 7 risk factors driving premature death and disability in England among 15 million people in midlife. This includes pulse rhythm, blood pressure and cholesterol. They are also supported to understand their risk of Cardiovascular Disease (CVD) and make positive behavioural changes that can prevent and delay the onset of CVD. For example, everyone having an NHS Health Check should benefit from personalised support and where appropriate access to services, such as stop smoking, weight management, physical activity, alcohol support and diabetes prevention.

    We will therefore focus on interventions such as:

    • Working with employers to grow a healthier, highly skilled workforce.
    • Improving wellbeing and mental health.
    • Preventing musculoskeletal (MSK) conditions by helping people stay fit, active and healthy.
    • Improving uptake of screening 7.
  • Theme 4: Ageing well

    There has been a steady increase in average life expectancy in recent decades, albeit increases have slowed considerably since 2011. This is a public health success story. Longer lives are a benefit to society in many ways, including financially, socially and culturally, because older people have skills, knowledge and experience that benefit the wider population. There is an opportunity to utilise this increased longevity as a resource, whilst challenging ageism and the view that retirement is about ‘sitting more and moving less’.

    The older a person is, the more likely they are to experience chronic diseases and disabilities of both the body and brain. As life expectancy rises, we must promote the concept of productive healthy ageing; improved health and wellbeing, increased independence and resilience to adversity, the ability to be financially secure through work and building resources, engagement in social activities, being socially connected with enhanced friendships and support, enjoying life in good health.

    The areas we will focus interventions on include:

    • Improving access to good employment.
    • Protecting health through improving housing and the built environment.
    • Increasing awareness and uptake of vaccinations.
    • Maintaining functional ability: brain and body health.
    • Preventing falls.
    • Preventing loneliness and social isolation.